亚急性皮肤型红斑狼疮23例临床分析

Character of subacute cutaneous lupus erythematosis

目的探讨亚急性皮肤型红斑狼疮的临床和病理表现,治疗经验及预后特点。方法回顾分析北京协和医院皮肤科2012年1月-2014年12月收治的23例亚急性皮肤型红斑狼疮患者的临床和组织病理特点以及治疗预后情况。结果皮损好发于面部,躯干;皮损主要表现为红斑,鳞屑性皮疹;典型的病理表现为表皮萎缩,基底层液化变性,真皮血管和附属器周围淋巴细胞为主的浸润;实验室检查以抗SSA抗体和ANA阳性为主要表现;治疗以羟氯喹,单用或合用激素治疗;大多数患者对治疗反应较好,部分患者出现反复。结论亚急性皮肤型红斑狼疮诊断主要依据典型的临床表现和实验室检查;羟氯喹和糖皮质激素是治疗亚急性皮肤型红斑狼疮的主要药物。

Objective To explore the clinical and histopathological manifestations, the therapy and prognosis of subacute cutaneous lupus erythematosis（SCLE）. Methods The clinical data and histopathological features of 23 patients with SCLE diagnosed at Peking Union Medical College Hospital from January 2012 to December 2014 were retrospectively reviewed. Results The lesions of SCLE tended to occur on face and trunk. The lesions appeared erythema and scale. Histopathological features were atrophy of epidermis, hydropicdegeneration of the basal layer, a primarily lymphocytic perivascular and perifollicular inflammation infiltration occurs in dermis. Laboratory examination revealed positive ANA and antibodies to SSA antigen. Most patients responded well to treatment, while a few experienced recurrence when the treatment tapped or discontinued. Conclusion The diagnosis of SCLE is mainly based on clinical findings and laboratory examination. Hydroxychloroquine and middle-dose glucocorticoids are effective for the treatment of SCLE.